Laryngitis

What is laryngitis?

The larynx joins the back of the throat to the trachea (windpipe). The vocal cords are in the larynx. Laryngitis means inflammation of the larynx. It is most commonly due to to a viral infection (viral laryngitis). Other causes are uncommon.

What are the symptoms of viral laryngitis?

You may feel sore over the 'Adam's apple' and become hoarse shortly afterwards. The voice sometimes 'goes', and you may only be able to whisper. Some people are alarmed at this. However, it is only temporary whilst the vocal cords are inflamed during the infection. You may also have a mild fever, and a cough. Sometimes laryngitis is part of a more widespread infection. For example, you may also have an infected throat (pharyngitis), tonsillitis, a cold, or a flu-like illness. In these situations, you may also have other symptoms such as a sore throat, headache, feeling tired, swollen neck glands, runny nose, pain on swallowing, and general aches and pains.

A typical viral laryngitis gets worse over 2-3 days. It then eases and goes, usually within a week. However, you may have a croaky voice for a week or so even after the other symptoms have gone. This is because the inflammation of the vocal cords may take a while to settle after the virus has gone.

Breathing difficulty is an uncommon complication. This may occur if there is a lot of inflammation and swelling in the larynx which causes the windpipe to narrow. This is rare in adults, but sometimes happens in young children with smaller, narrower windpipes. See a doctor urgently if you have any difficulty in breathing with a laryngitis.

What is the treatment for viral laryngitis?

• Not treating is an option as laryngitis usually gets better within a few days.
• Have plenty to drink as it is tempting not to drink very much if it is painful to swallow. You may become mildly dehydrated if you don't drink much. Mild dehydration can make headaches and tiredness much worse.
• Paracetamol or ibuprofen ease pain, headache, and fever. To keep symptoms to a minimum it is best to take a dose at regular intervals as recommended on the packet of medication rather than 'now and then'. For example, take paracetamol four times a day until symptoms ease.
• Aspirin gargles will do little to ease soreness in the larynx. This is because a gargle does not touch the larynx, it only touches the back of the throat. However, it may ease a sore throat if this occurs with a laryngitis. (There is little research evidence to confirm that aspirin gargles are effective for sore throat. However, it is a popular treatment and may be worth a try.) If used, dissolve some soluble aspirin in water and gargle for 3-4 minutes. You can do this 3-4 times a day. Spit out the aspirin after gargling. (Note: you should not give aspirin to children under 16.)
• Other gargles, lozenges, and sprays which you can buy may help to soothe a sore throat, but again will do little to help with soreness in the larynx. They tend to be expensive, and may do little extra to ease symptoms than the above measures.
• Breathing in humidified air is said to help although there is no scientific evidence to prove this. The theory is that moisture in the airways may be soothing and may help to clear secretions. However, not many people have a humidifier.

What about using or resting my voice?

Rest your voice, if possible, when you have laryngitis. If you overuse your voice when the vocal cords are inflamed, it may make the inflammation worse. It is unlikely to do any permanent damage, but it may take longer for your normal voice to return. Resting the voice means not shouting, singing, or talking for long periods. Quiet conversation is usually fine. A 'sighing' soft speech is best rather than whispering until the laryngitis has gone. This is because whispering makes your larynx work harder than soft 'sighing' speech.

If you are a performer such as a singer, it can be a difficult decision as to when to start singing again. Singing too early, when symptoms are easing, may prolong the hoarse voice longer than if you rest it fully until symptoms have completely gone. There is no easy answer as to the earliest it is safe to sing without doing any more harm. A professional singer may wish to consult a speech therapist if a crucial decision is to be made about an important singing engagement.

Do I need an antibiotic?

Usually not. Laryngitis is usually caused by a virus. Antibiotics do not kill viruses, they only kill bacteria. Your immune system usually clears virus infections quickly. A more severe laryngitis is sometimes due to bacteria. An antibiotic may be advised if the infection is severe, if it is not easing after a few days, or if your immune system is not working properly (for example, if you have had your spleen removed or if you are taking chemotherapy).

Other causes of laryngitis and hoarseness

Laryngitis and hoarseness are occasionally due to other conditions that affect the vocal cords. For example: rare infections, allergies, voice overuse, reflux of acid from the stomach, tobacco smoke, or other irritants or chemicals that you may inhale. A benign (non-cancerous) cyst on a vocal cord sometimes causes hoarseness. A tumour (cancer) on the vocal cord is an uncommon cause. See a doctor if any of the following develop:

• Symptoms that are severe, or are different to those described above.
• Any flu-like symptoms that do not ease within 3-4 days.
• If hoarseness or soreness in the larynx persist more than 2-3 weeks. Particularly if you have had no initial infection to account for the hoarseness.
• If swollen neck glands do not go within 2-3 weeks after an infection.
• If swollen glands appear in the neck without symptoms of infection.

Further help and information

British Voice Association

Web: www.british-voice-association.com
May be of help if you have a voice-related problem and need professional advice.